An Explanatory Model for the Relationship Between Physical Therapists' Self-perceptions of Value and Care Prioritization Decisions in the Acute Hospital
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2021-10
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<jats:sec> <jats:title>Purpose:</jats:title> <jats:p>The aim of the study was to understand how acute care physical therapists' perceptions of the value of physical therapy inform their decisions regarding which patients to treat.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>This was a qualitative study using a grounded theory approach. Data were collected using semistructured interviews with a purposive sample of acute hospital physical therapists in the United States. Interview transcriptions were analyzed to derive codes and identify an explanatory model.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Participants included 16 physical therapists from 4 hospital systems. Their descriptions indicate that care prioritization is influenced by a self-perception of value informed by both patient- and system-driven thinking. Patient-driven thinking prioritizes factors considered most important to individual patients (eg, improved functional independence). System-driven thinking prioritizes factors most important to the health system (eg, a certain patient population or productivity expectation). The relative contribution of system- and patient-driven thinking in prioritization decisions was variable from one participant to another.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>In addition to the perceived value of physical therapy for individual patients, acute hospital physical therapists integrate organization-level factors into prioritization decisions. Future research should seek to understand how this may influence practice variation and identify practice patterns that simultaneously optimize outcomes considered important by both patients and organizations.</jats:p> </jats:sec>
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Johnson, Joshua K, Daniel L Young and Robin L Marcus (2021). An Explanatory Model for the Relationship Between Physical Therapists' Self-perceptions of Value and Care Prioritization Decisions in the Acute Hospital. Journal of Acute Care Physical Therapy, 12(4). pp. 165–184. 10.1097/jat.0000000000000157 Retrieved from https://hdl.handle.net/10161/30528.
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Joshua Kurt Johnson
As a physical therapist researcher, I seek to better understand and improve rehabilitation care delivery using the learning health system framework. This prompts overlap in my work between data science and implementation science. I have the opportunity to use various sources of health data and engage in multiple quantitative and qualitative research methods. My work also lends naturally to partnership with healthcare leaders and clinicians. To facilitate this work, I have several roles at Duke University. In the School of Medicine, I am an Assistant Professor in the Division of Physical Therapy, Department of Orthopaedic Surgery, and Department of Population Health Sciences. I am also the Clinical Research Lead for the Duke University Health System Department of Rehabilitation and a member of the Duke Clinical Research Institute. Prior to joining the faculty at Duke, I was the Director of PM&R Outcomes Research at Cleveland Clinic. My PhD training was at the University of Utah. I hold a Doctor of Physical Therapy degree from Arcadia University and Bachelors degree in Athletic Training from Brigham Young University.
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